Can Men Have Bacterial Vaginosis?

Bacterial Vaginosis (BV) is not considered a traditional sexually transmitted infection (STI), but a recently published study by the New England Journal of Medicine offers evidence that sexual activity can cause BV.

An imbalance of bacteria leads to BV, which is the most common cause of vaginal discharge. And while men cannot get bacterial vaginosis, the recent study has brought renewed interest in the role that male sexual partners play in recurring bacterial vaginosis in their female partners.

Just like the vagina, the penis and penile urethra are home to a variety of bacteria. These do not cause infections or symptoms in men, but bacteria from a male partner can lead to a bacterial imbalance in a female partner, causing BV.

The NEJM study enrolled 164 cisgender, heterosexual couples and randomly assigned them to one of two groups. In the first group, only the female partner with bacterial vaginosis received antibiotic treatment, and in the other, both the female partner with BV and her male sexual partner received treatment.

After following 150 couples for 12 weeks, the study showed that treating both the female and male partner resulted in far fewer repeat BV infections in the female partner.

So, Is Bacterial Vaginosis a Sexually Transmitted Infection (STI)?

No. UR Medicine experts Erin Duecy, MD, and Joseph Panza, MD, explain this is because you don’t have to have sex to get BV. But the connection to sexual partners is still being explored.

According to Dr. Duecy and Dr. Panza, “We don’t know if the increase in recurrent BV is because sexual partners are passing certain bacteria that are more likely to cause bacterial vaginosis, or if the normal bacteria exchanged during sex disrupts the bacterial balance in the vagina, allowing species like Gardnerella—the bacteria responsible for BV—to overgrow.”

In STIs, specific disease-causing bacterial species are passed from one partner to the other.

However, BV is like an STI in that:

• It occurs four days after sexual activity
• Sexual activity with a new partner is a risk factor for a new diagnosis of BV
• Sex with a frequent partner is associated with repeat, or recurrent, episodes of BV

The Truth About Bacteria

In general, bacteria have a bad reputation. They are responsible for a variety of diseases, from strep throat to stomach ulcers, but not all bacteria are bad.

In recent years, the medical community has learned more about the microbiota of the human body. “Microbiota” is the normal diversity of bacteria, viruses, fungi, and other organisms that live in harmony with bodily systems.

The key to a healthy microbiota is balance. When there is too much or two little of one type of bacteria, it can lead to health problems ranging from discomfort to cancer. One popular example of balancing healthy bacteria is using probiotics to maintain good gut bacteria in the digestive tract.

Like the digestive tract, the vagina also has a microbiome. Typically, the most common bacterial species in the vaginal microbiota is Lactobacillus. Other organisms, such as Gardnerella, are present but at much lower numbers.

What Causes BV?

The bacterial imbalance in BV can be caused by:

• Douching
• Antibiotic use
• Natural lack of lactobacilli bacteria in the vagina
• Smoking
• Using certain IUDs
• Genetics

Treatment usually involves antibiotics to restore a healthy bacterial balance.